New proposals to encourage use of patient packs
Dispensers could be allowed to round the quantity ordered on a prescription, in order to enable original patient pack dispensing, under proposals put out to consultation by the Department of Health last week (PJ,
10 September,
p299).
Such rounding would be allowed within certain limits, such as 10 or 20
per cent, and would have to be indicated on NHS prescriptions. It would
allow pharmacists to dispense 28 tablets where 30 have been prescribed
and vice versa. However, pharmacists would be reimbursed for the actual
quantity prescribed.This would apply to both calendar packs and other
patient packs. Doctors would be able to indicate on prescriptions occasions
on which the exact quantity prescribed should be dispensed.
In the consultation,
“Proposals to simplify the reimbursement arrangements for NHS dispensing
contractors”, the DoH says it wants to support the use of patient
pack dispensing, where possible,“because of the benefits this will
have for patient safety and because it will help us make better use of
pharmacists’ skills (less time will be spent on ‘snipping’)”.
For calendar packs, the DoH proposes that contractors should be allowed
to dispense either the amount prescribed or the calendar pack, or subpack,
nearest to it, but still be paid for the quantity prescribed.
The consultation also puts forward a number of other proposals, aiming
to make the rules more transparent.
The DoH also proposes that:
· A monthly allowance should replace individual
broken bulk claims on readily available medicines
· A list of the top 150 or so specials should
be added to the Drug Tariff
· A monthly allowance should replace outof-
pocket expense claims
· The list of commonly used pack sizes should
be abolished and, when they fail to indicate a pack size, contractors
should be paid for the cheapest pack
· Zero discount lists should be abolished,
although a number of products, including Controlled Drugs, should continue
to be reimbursed at full price
Lindsay McClure, head of information services at the Pharmaceutical Services
Negotiating Committee, said: “The PSNC will be considering the Department’s
proposals at its meeting in late September and will respond fully to the
consultation in due course.We will be looking in particular at the financial
ramifications of the proposals. Although the £500m purchase profit
as part of the new contract is assured, the significant proposed changes
need to be carefully considered to ensure that they do not impact adversely
on certain contractors.”
John D’Arcy, chief executive of the National Pharmacy Association,
said: “It will become very difficult to manage a business. How the
Drug Tariff price relates to your usage of products will be harder to
determine.”
Mr D’Arcy added that the Government’s obligation under European
law to enable original pack dispensing means that it is right for pharmacists
to be allowed to round up prescriptions to whole pack sizes, but that
they should not then be expected to pick up the cost of that themselves.
“This could be catastrophic depending on which side of the swing
or roundabout you fall,” he said.
The consultation closes on 30 November 2005. |
The
Pharmaceutical Journal
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